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How can we trust figures on recruits?

In the debate about the numbers of additional doctors recruited in the past few years, little prominence has been given to the effect of the changes in registration arrangements introduced a few years ago. The effects are significant.

When supplementary lists were introduced a large number of non-principals who were previously not counted were added to the total number of doctors working in primary care. Although this is a simple head count, many worked part-time, some for only two or three sessions a week. A number of these doctors also work as part-time principals and so are included in both the principal and supplementary lists. These doctors are counted twice.

When the supplementary lists were introduced, non-principals had to be registered on the lists of any PCT in whose area they might work. Some would be registered on two or even three supplementary lists and may also have been part-time principals. They would be counted three or even four times.

This requirement was dropped, but given the lack of cohesion between the various NHS authorities it would not be surprising if many non-principals remain on several supplementary lists.

Given all this confusion it is possible that the extra 2,000 GPs we are told have been recruited in the past few years might actually be as few as 500 whole-time equivalents. The truth is that we may never know.

Spin like this can make you so giddy that you lose all sense of reality – or has this already happened at the Department of Health?

Michael Blackmore

Independent GP, Ringwood


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